Clinical and Autopsy Parameters of Acute Medical Deaths in an Emergency Facility in South-West Nigeria

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dc.contributor.authorAjuluchukwu, JNA
dc.contributor.authorAbdulkareem, FB
dc.contributor.authorAchusi, IB
dc.contributor.authorMbakwem, AC
dc.date.accessioned2020-07-16T16:07:09Z
dc.date.available2020-07-16T16:07:09Z
dc.date.issued2013
dc.description.abstractBackground: Acute medical deaths are usually consequences of acute critical diseases, or acute exacerbations of chronic diseases. Thus, autopsy – confirmed characteristics would provide support for future management strategies. Objectives: To examine clinical and autopsy parameters including causes of death (COD) and mechanisms of death (MOD) among acute medical deaths. Methods: A 5-year (2005–2009) retrospective analysis was undertaken of Emergency Department (ED) related medical deaths occurring <24 hours after presentation. Case-notes provided clinical details while autopsy records supplied the COD and MOD respectively. Results: Decedents were 250 males (58.5%) and 177 females (41.5%), (male: female ratio=1.4: 1), predominantly (78%) young; with mean age of 43.7±16.6 years. In 22.8%, symptom duration was <1 day but >4 days in 42.8%. Coma –36%, and dyspnoea –10% prompted early presentation; but late presentation (>4days) characterised cough (4%), fever (10%), and body swelling (19%). Of the total, 23% presented after 10 pm, 16% were “dead on arrival” (DOA), and 40% died within six hours of arrival. Three commonest CODs were circulatory-cardiovascular disease [CVD](36%), infections/ septicaemia (18%), and malignancies (8.4%). CVD subset was older (52 years), with significant male preponderance (62.5% vs 37.5%; p<0.05); but comparable mean age in both sexes. Common MODs were cerebral dysfunction (29%) – including sub-types of intra-cerebral haemorrhage (51.8%) and tonsillar herniation (33.3%), heart failure (19%), and septicaemia (15%). Conclusion: The highlights were late presentation, early demise from communicable and noncommunicable diseases; and common “exit” mechanisms of septicaemia, heart failure and cerebral dysfunction. These data will guide management and preventive strategies.en_US
dc.identifier.citationYear : 2013 | Volume : 10 | Issue : 1 | Page : 21-26en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/8590
dc.language.isoenen_US
dc.publisherJournal of clinical sciencesen_US
dc.subjectAcute medical mortality, late presentation, cause of death, mechanism of death; cardiovascular disease, emergency department.en_US
dc.titleClinical and Autopsy Parameters of Acute Medical Deaths in an Emergency Facility in South-West Nigeriaen_US
dc.typeArticleen_US
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